Are gastric cancer resection margin proteomic profiles more similar to those from controls or tumors?

A strategy for treating cancer is to surgically remove the tumor together with a portion of apparently healthy tissue surrounding it, the so-called "resection margin", to minimize recurrence. Here, we investigate whether the proteomic profiles from biopsies of gastric cancer resection margins are indeed more similar to those from healthy tissue than from cancer biopsies. To this end, we analyzed biopsies using an offline MudPIT shotgun proteomic approach and performed label-free quantitation through a distributed normalized spectral abundance factor approach adapted for extracted ion chromatograms (XICs). A multidimensional scaling analysis revealed that each of those tissue-types is very distinct from each other. The resection margin presented several proteins previously correlated with cancer, but also other overexpressed proteins that may be related to tumor nourishment and metastasis, such as collagen alpha-1, ceruloplasmin, calpastatin, and E-cadherin. We argue that the resection margin plays a key role in Paget's "soil to seed" hypothesis, that is, that cancer cells require a special microenvironment to nourish and that understanding it could ultimately lead to more effective treatments.

Computed tomography-guided navigated transcranial magnetic stimulation for preoperative brain motor mapping in brain lesion resection: A case report.

BACKGROUND: Navigated transcranial magnetic stimulation (nTMS) is a well establish a noninvasive method for preoperative brain motor mapping. We commonly use magnetic resonance imaging (MRI) to supply the nTMS system. In some cases, MRI is not possible or available, and the use of computed tomography (CT) is necessary. We present the first report describing the association of CT and nTMS motor mapping for brain lesion resection. CASE DESCRIPTION: CT imaging of a 59-year-old man suffering from acquired immune deficiency syndrome for 17 years, presenting with seizure and right hemiparesis, revealed a small single hypodense ring-enhancing lesion in the left central sulci suggesting cerebral toxoplasmosis. After 3 weeks of neurotoxoplasmosis treatment, due to four consecutive tonic-clonic seizures, a new CT scan was performed and showed no lesion changes. MRI was in maintenance at that time. Infectious diseases department suggested a brain lesion biopsy. Due to lesion's location, we decided to perform a presurgical nTMS motor mapping. After a small craniotomy, we could precisely locate and safely totally remove the lesion. The pathology report revealed a high suspicious toxoplasmosis pattern. The patient was discharged after 2 days and continued toxoplasmosis treatment. After 6 months follow-up, he showed no signs of any procedure-related deficits or radiological recurrence. CONCLUSION: We report the feasibility and applicability of nTMS motor mapping using CT scan as an image source. It gives neurosurgeons another possibility to perform motor mapping for brain lesion removal, especially when MRI is not available or feasible.

Microsurgical Treatment of Intraventricular Cavernoma with Prior Planning Neuroendoscopy.

Microsurgery remains the gold standard treatment for intraventricular lesions, but it is not without limitations. The cerebral ventricles approach is considered a challenge for neurosurgeons because of their deep location and their intimate association with critical areas of the brain. It has been shown that direct endoscopic view is superior to magnetic resonance imaging (MRI) in identifying intraventricular structures and lesions. Also, during neuroendoscopy, there is no cerebrospinal fluid leak causing brain collapse as seen in microsurgery. Different surgical strategies should be shared and may improve and facilitate intraventricular lesions resection. Herein, a case of a successful microsurgical cavernoma resection with prior ventriculoscopy is described. A 28-year-old woman was admitted with intense holocranial headache. A mild stiff neck was observed. MRI showed a 3-cm lesion with heterogeneous signal intensity and no contrast enhancement suggestive of cavernoma. Initially, a ventriculoscopy was done to inspect the lesion and the surrounding ventricular structures. After that, a conversion technique from endoscopy to microsurgery was performed. The initial corticectomy was extended and the endoscope pathway was followed into the ventricular cavity. Then, the cavernoma was completely removed by microsurgical technique. No complications were observed. Control MRI showed total tumour removal. The patient remained asymptomatic with no recurrence after 1 year. This case illustrates a successful prior endoscopic approach followed by microsurgery as an alternative to a direct microsurgical approach for intraventricular cavernoma. A previous direct endoscopic view of the lesion and its relation with intraventricular structures may ensure a safe and complete resection by microsurgery.

Solid pseudopapillary tumor of the pancreatic: evaluation of clinical, radiological and surgical profiles.

OBJECTIVE: To describe the clinical, radiological and surgical features of solid pseudopapillary tumor of the pancreas. METHODS: We conducted a retrospective, observational study evaluating the multi-institutional clinical, radiological and surgical patients with a diagnosis of solid pseudopapillary tumor of the pancreas undergoing surgical treatment. RESULTS: We identified eight patients in three hospitals in the state of Amazonas, seven females, six under the age of 30. The neoplasia predominated in the head of the pancreas. Five patients underwent pancreaticoduodenectomy, one enucleation, one distal pancreatectomy, and one was considered unresectable. CONCLUSION: Solid pseudopapillary tumor of the pancreas predominated in young female patients, predominantly located in the pancreatic head.

Tumor sólido pseudopapilar do pâncreas: avaliação do perfil clínico, radiológico e cirúrgico / Solid pseudopapillary tumor of the pancreatic: evaluation of clinical, radiological and surgical profiles

OBJETIVO: descrever perfil clínico-cirúrgico do tumor sólido pseudopapilar do pâncreas. MÉTODOS: estudo observacional retrospectivo multi-institucional avaliando as características clínicas, radiológicas e cirúrgicas dos pacientes com diagnóstico de tumor sólido pseudopapilar do pâncreas submetidos a tratamento cirúrgico. RESULTADOS: foram identificados oito pacientes em três hospitais no estado do Amazonas, sendo sete do sexo feminino, seis com menos de 30 anos. A neoplasia predominou na cabeça do pâncreas. Cinco pacientes foram submetidos à duodenopancreatectomia, um à enucleação, um à pancreatectomia corpocaudal e o último foi considerado irressecável. CONCLUSÃO: o tumor sólido pseudopapilar do pâncreas predominou em pacientes jovens do sexo feminino, com localização predominante na cabeça do pâncreas.

OBJECTIVE: To describe the clinical, radiological and surgical features of solid pseudopapillary tumor of the pancreas. METHODS: We conducted a retrospective, observational study evaluating the multi-institutional clinical, radiological and surgical patients with a diagnosis of solid pseudopapillary tumor of the pancreas undergoing surgical treatment. RESULTS: We identified eight patients in three hospitals in the state of Amazonas, seven females, six under the age of 30. The neoplasia predominated in the head of the pancreas. Five patients underwent pancreaticoduodenectomy, one enucleation, one distal pancreatectomy, and one was considered unresectable. CONCLUSION: Solid pseudopapillary tumor of the pancreas predominated in young female patients, predominantly located in the pancreatic head.